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. Author manuscript; available in PMC: 2016 Apr 25.
Published in final edited form as: J Vasc Surg. 2013 Jan;57(1):301. doi: 10.1016/j.jvs.2012.11.056

Reply. Regarding “Impact of screening versus symptomatic measurement of deep vein thrombosis in a national quality improvement registry”

Randall R De Martino 1, Philip P Goodney 1
PMCID: PMC4843512  NIHMSID: NIHMS777523  PMID: 23261280

Reply

We would like to thank Drs Wakefield and Birkmeyer for their insightful comments regarding our article. Their editorial emphasizes the prominent role that the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) plays nationally in quality improvement. Further, they highlight the myriad of ways in which a hospital's deep vein thrombosis (DVT) rates can be confounded by the manner in which one looks for, and measures, this important complication.

We suspect that most practicing surgeons are acutely aware that if one looks hard enough for trouble, you're likely to find it. Venous thromboembolism (VTE) events remain potentially preventable, thus an identifiable target for quality improvement and measurement. But, measuring results and improving quality requires that everyone “looks” for complications, and records their results, in the same manner. We agree with the group from Michigan-who are national leaders in VTE detection, measurement, and prevention,1-3 that ACS-NSQIP needs standardized definitions to describe the manner is which the DVT was detected (symptomatic versus surveillance). Then, centers can understand their results in a meaningful manner to identify areas for improvement.

References

  • 1.Finks JF, English WJ, Carlin AM, Krause KR, Share DA, Banerjee M, et al. Predicting risk for venous thromboembolism with bariatric surgery: results from the Michigan Bariatric Surgery Collaborative. Ann Surg. 2012;255:1100–4. doi: 10.1097/SLA.0b013e31825659d4. [DOI] [PubMed] [Google Scholar]
  • 2.Birkmeyer NJ, Dimick JB, Share D, Hawasli A, English WJ, Genaw J, et al. Hospital complication rates with bariatric surgery in Michigan. JAMA. 2010;304:435–42. doi: 10.1001/jama.2010.1034. [DOI] [PubMed] [Google Scholar]
  • 3.Ramacciotti E, Blackburn S, Hawley AE, Vandy F, Ballard-Lipka N, Stabler C, et al. Evaluation of soluble P-selectin as a marker for the diagnosis of deep venous thrombosis. Clin Appl Thromb Hemost. 2011;17:425–31. doi: 10.1177/1076029611405032. [DOI] [PMC free article] [PubMed] [Google Scholar]

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